This application relates to devices for use in minimally invasive or endoscopic surgery, and, in particular, to a device which can be used to insert surgical tools into patient cavities, such as an abdominal cavity.
Endoscopic or minimally invasive surgery has become fairly common and is becoming more and more common as surgeons learn and advance endoscopic technology and techniques. Currently, endoscopic surgery is used for procedures conducted in the sinus cavities, on the spine, on knees, on feet, in the abdominal cavity, and in the thoracic cavity. As the technology (i.e., the surgical instruments) and techniques advance, endoscopic surgery will become even more prevalent.
Generally, minimally invasive surgery, when performed in the abdominal cavity, involves making an incision 11 (FIG. 1) in a patient's umbilicus to pass an endoscope E (FIG. 1) into the abdominal cavity A. The endoscope used has a rigid tube T which contains a light source and a camera. Signals from the camera are sent to a monitor to enable a surgeon to view the operating field. A surgical instrument ST is inserted through a second incision 12 in the patient's abdomen. If multiple surgical instruments are needed, then an incision will have to be made for each instrument used.
Because endoscopic surgery involves the use of smaller incisions, and because it generally takes less time than the corresponding conventional abdominal procedure, improvements can still be made. For example, in an abdominal procedure, the abdominal cavity must be inflated to provide space for the surgeon to conduct the procedure. However, some procedures must be conducted without the use of gas. In such gasless procedures, the use of a tissue lifter is required, necessitating making an additional incision, for example, in the patient's abdomen. Further, with the endoscopic tube passing through the patient's navel, the tube T is taking a position that could otherwise be used by other surgical instruments. It would be beneficial to free up the patient's umbilicus for the insertion of additional surgical tools, when and if necessary.
Additionally, with reference to FIG. 1, the tube T extends below the abdominal wall (for abdominal procedures). Hence, the end of the tube T is not fixed in place relative to the abdominal wall. Any movement of the tube T or of the abdominal wall can cause the end of the tube T within the abdominal cavity to move or pivot. As can be appreciated, such moving or pivoting of the end of the tube will change the field of view of the camera. Such changes in the field of view, when unexpected, can make the surgery more difficult. Hence it would also be desirable to provide a camera or imaging system, which is substantially fixed relative to the wall of the cavity in which the camera is positioned.